Functional seizures and their mimics: a retrospective service review of cases from a tertiary video telemetry database.

Autor:	Dudley P; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK., Marquez JP; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK., Farrell F; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK., Benson J; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK., Rugg-Gunn F; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK.; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.; NIHR University College London Hospitals Biomedical Research Centre, University College London, London, UK., Sidhu MK; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK.; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.; NIHR University College London Hospitals Biomedical Research Centre, University College London, London, UK., O'Sullivan S; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK.; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.; NIHR University College London Hospitals Biomedical Research Centre, University College London, London, UK., Walker M; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK.; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.; NIHR University College London Hospitals Biomedical Research Centre, University College London, London, UK., Yogarajah M; Department of Epilepsy, Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, UK.; Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK.; NIHR University College London Hospitals Biomedical Research Centre, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ neurology open [BMJ Neurol Open] 2024 Aug 06; Vol. 6 (2), pp. e000738. Date of Electronic Publication: 2024 Aug 06 (Print Publication: 2024).
DOI:	10.1136/bmjno-2024-000738
Abstrakt:	Objective: Identify the proportion of patients referred with putative functional seizures (FS) that were subsequently re-diagnosed as epileptic seizures (ES), or an alternative diagnosis, following video telemetry EEG (VTEEG). In addition, describe the characteristics of those seizures. Methods: The VTEEG reports from patients admitted to the Chalfont Centre for Epilepsy between 2019 and 2022 were reviewed. Pre-VTEEG and post-VTEEG diagnoses were compared to identify whether a diagnostic revision was made from suspected FS to ES or another diagnosis. Diagnostic revision cases were then grouped into cohorts with associated features and reviewed to characterise and describe FS mimics. Results: 444 VTEEG reports where patients had habitual events were identified. 4.7% of patients were referred with FS and were subsequently diagnosed with ES or another diagnosis. In this group, several cohorts could be identified including frontal lobe epileptic seizures, ES with functional overlay, insular or temporal lobe epileptic seizures associated with autonomic or marked experiential peri-ictal symptoms, and individuals who had both ES and FS but whose ES were revealed on medication withdrawal. Conclusion: In patients referred to a tertiary epilepsy unit, a small minority of cases had seizures diagnosed as functional and reclassified as epileptic or an alternative diagnosis. It is clinically important to be aware of these FS mimics. Competing Interests: MY carries out independent expert medicolegal work including in relation to functional neurological disorders. (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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